Nefopam

Indications

Nefopam hydrochloride is a pain reliever used for moderate to severe short-term (acute) pain, such as pain after surgery, injury, dental pain, musculoskeletal pain and some other painful conditions, when simpler painkillers are not enough.

How It Works

Nefopam is a non-opioid, non-anti-inflammatory painkiller that acts in the brain and spinal cord. It reduces the reuptake of serotonin, noradrenaline and dopamine, which strengthens the body's own pain-control pathways, and it also affects some nerve channels involved in pain signals. It does not reduce inflammation or fever.

Dosage and Administration

Take as prescribed. For adults, tablets are commonly started at 60 mg three times a day, adjusted by the doctor within the range of 30 mg to 90 mg three times a day. Older people usually start at a lower dose. The injection is given by a doctor or nurse, slowly, with the patient lying down.

Interactions

• Do not use with monoamine oxidase inhibitors (MAOIs).
• Tricyclic antidepressants, antihistamines and other anticholinergic medicines increase side effects such as dry mouth, urinary retention and fast heartbeat.
• Other medicines that lower the seizure threshold (such as Tramadol and some antidepressants) increase the risk of fits.
• Alcohol and sedatives add to drowsiness.

Contraindications

• Allergy to Nefopam.
• Epilepsy or a history of seizures.
• Use with MAOIs.
• Heart attack (myocardial infarction).
• Narrow-angle glaucoma or difficulty passing urine due to an enlarged prostate (because of its anticholinergic effects).

Side Effects

Common side effects include nausea, vomiting, sweating, dry mouth, dizziness, drowsiness, nervousness, fast heartbeat and difficulty passing urine. It may turn urine pink, which is harmless.

Get urgent medical help if you have a fit (seizure), confusion or hallucinations, a very fast or irregular heartbeat, inability to pass urine, or signs of a severe allergic reaction.

Pregnancy and Lactation

Safety in pregnancy is not established; use only if your doctor considers it necessary. It may pass into breast milk; avoid breastfeeding unless your doctor advises otherwise.

Precautions and Warnings

• Use with care in older people and in liver or kidney disease; lower doses may be needed.
• It may cause dizziness or drowsiness; do not drive or operate machinery if affected.
• It is meant for short-term use; follow your doctor's advice on how long to take it.

Overdose

Overdose can cause seizures, hallucinations, fast heartbeat, agitation and coma, and can be life threatening. Seek emergency medical help immediately.

Therapeutic Class

Centrally acting non-opioid analgesic.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.